[1]李鸿渐,顾洪学,尹 杰,等.CCTA定量参数结合血清PDCD5、H-FABP对经皮冠状动脉介入术后心肌损伤的评估价值[J].介入放射学杂志,2026,(09):977-984.[doi:10.3969/j.issn.1008-794X.2026.09.003]
　LI Hongjian,GU Hongxue,YIN Jie,et al.The clinical value of CCTA quantitative parameters combined with serum PDCD5 and H-FABP in evaluating myocardial injury after percutaneous coronary intervention[J].J Intervent Med,2026,(09):977-984.[doi:10.3969/j.issn.1008-794X.2026.09.003]
点击复制

CCTA定量参数结合血清PDCD5、H-FABP对经皮冠状动脉介入术后心肌损伤的评估价值()

PDF下载中关闭

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年09
页码:
977-984
栏目:
心脏介入
出版日期:
2026-09-10

文章信息/Info

Title:
The clinical value of CCTA quantitative parameters combined with serum PDCD5 and H-FABP in evaluating myocardial injury after percutaneous coronary intervention
文章编号:
1008-794X(2026)-009-0977-08
作者:
李鸿渐;  顾洪学;  尹 杰;  王思月
271199 山东济南 山东第一医科大学附属人民医院(济南市人民医院)心内科
Author(s):
LI Hongjian; GU Hongxue; YIN Jie; WANG Siyue.
Department of Cardiology,Affiliated People's Hospital of Shandong First Medical University(Jinan Municipal People's Hospital),Jinan,Shandong Province 271199,China
关键词:
冠心病;  经皮冠状动脉介入术;  心肌损伤;  不良心血管事件;  冠状动脉CT血管成像;  程序化细胞死亡分子5;  心型脂肪酸结合蛋白
分类号:
R541.4
DOI:
10.3969/j.issn.1008-794X.2026.09.003
文献标志码:
A
摘要:
目的 探讨冠状动脉CT血管成像(coronary computed tomography angiography,CCTA)定量参数结合血清程序化细胞死亡分子5(programmed cell death 5,PDCD5)、心型脂肪酸结合蛋白(heart-type fatty acid binding protein,H-FABP)对经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后心肌损伤的评估价值。方法 回顾性分析2019年6月至2024年6月在济南市人民医院择期行PCI治疗的冠心病患者临床资料。根据术后是否出现心肌损伤分为损伤组和未损伤组,根据术后1年不良心血管事件(major adverse cardiovascular events,MACE)发生情况将患者分为MACE组和未MACE组,均在术前进行CCTA并检测血清PDCD5、H-FABP水平。比较两组间CCTA定量参数和血清PDCD5、H-FABP水平差异,ROC曲线分析CCTA定量参数、血清PDCD5、H-FABP对PCI术后心肌损伤的诊断价值及对术后1年心血管死亡的预测价值。结果 最终入组423例,其中179例患者PCI术后出现心肌损伤,余244例患者未发生心肌损伤。2组患者临床资料比较差异均无统计学意义(P>0.05)。与未损伤组比较,损伤组管腔狭窄率、斑块总体积、斑块负荷、钙化斑块占比以及血清PDCD5、H-FABP水平更高(P<0.05); 斑块总体积、斑块负荷、血清PDCD5、H-FABP水平均为PCI术后心肌损伤的危险因素(P<0.05); CCTA测量的斑块总体积、斑块负荷、血清PDCD5、H-FABP单独诊断PCI后心肌损伤的AUC分别为 0.925、0.808、0.762、0.819,而联合诊断的AUC为0.985。423例患者中,43例术后1年发生MACE,MACE组管腔狭窄率、斑块总体积、斑块负荷、血清PDCD5、H-FABP水平均高于未MACE组(P<0.05); 管腔狭窄率、斑块总体积、血清PDCD5、H-FABP水平均为PCI术后1年MACE的危险因素; CCTA测量的管腔狭窄率、斑块总体积、血清PDCD5、H-FABP单独诊断PCI术后1年MACE的AUC在0.681～0.916范围,联合诊断的AUC为0.976。结论 CCTA定量参数结合血清PDCD5、H-FABP对PCI术后心肌损伤以及短期预后具有一定的预测价值。

参考文献/References:

[1] Saravanan S,Palaniappan NA,Panneerselvam A,et al.Emerging therapeutic and diagnostic strategies for coronary artery disease:Current trends and future perspectives[J].Curr Probl Cardiol,2024,49:102863.
[2]Chen X,Bai W,Qi P,et al.Perioperative myocardial injury/Infarction in patients with stable or unstable angina pectoris undergoing elective percutaneous coronary intervention:the effects of preoperative lipid management[J].Int J Gen Med,2025,18:939-945. [3]张舒宁,李 琨,王 英,等.基于CCTA的Ⅱ型糖尿病患者冠周脂肪衰减指数、CT血流储备分数及血清胱抑素C与冠状动脉狭窄程度的相关性研究[J].临床放射学杂志,2025,44:1427-1432.
Zhang SN,Li K,Wang Y,et al.Association of pericoronary adipose tissue attenuation index CT-derived fractional flow reserve and serum cystatin C with coronary artery stenosis severity in patients with type Ⅱ diabetes mellitus:a coronary CT angiography-based study[J].J Clin Radiol,2025,44:1427-1432.
[4]范慧娟,陈长英,李海禹,等.血清GDF15、FGF23联合CCTA定量参数对冠心病患者PCI术后MACE的预测价值[J].分子诊断与治疗杂志,2025,17:573-576.
Fan HJ,Chen CY,Li HY,et al.Predictive value of serum GDF15,FGF23 and CCTA quantitative parameters for MACE in patients with coronary heart disease after PCI[J].J Mol Diagn Ther,2025,17:573-576.
[5]Weng L,Ye J,Yang F,et al.TGF-β1/SMAD3 regulates programmed cell death 5 that suppresses cardiac fibrosis post-myocardial infarction by inhibiting HDAC3[J].Circ Res,2023,133:237-251.
[6]Chang X,Guo Y,Wang J,et al.Heart-type fatty acid binding protein as an early biomarker in sepsis-induced cardiomy-opathy:a prospective observational study[J].Lipids Health Dis,2024,23:283.
[7]Silvain J,Zeitouni M,Paradies V,et al.Procedural myocardial injury,infarction and mortality in patients undergoing elective PCI:a pooled analysis of patient-level data[J].Eur Heart J,2021,42:323-334.
[8]世界中医药学会联合会介入心脏病专业委员会,中华中医药学会介入心脏病专业委员会,中国中西医结合学会心血管病专业委员会介入心脏病学组,等.经皮冠状动脉介入治疗围手术期心肌损伤中医诊疗专家共识[J].中国中西医结合杂志,2017,37:389-393.
Interventional Cardiology Committee of the World Federation of Chinese Medicine Societies,Interventional Cardiology Committee of the Chinese Society of Chinese Medicine,Interventional Cardiology Group of the Cardio-Cerebrovascular Disease Committee of the Chinese Association of Integrative Medicine,et al.Expert Consensus on TCM Diagnosis and Treatment of Perioperative Myocardial Injury in Percutaneous Coronary Intervention[J].Chin J Integr Tradit West Med,2017,37:389-393.
[9]中国医师协会检验医师分会心血管专家委员会.心肌肌钙蛋白实验室检测与临床应用中国专家共识[J].中华医学杂志,2021,101:2947-2961.
Cardiovascular Expert Committee of the Chinese Medical Doctor Association Laboratory Medicine Branch.Chinese Expert Consensus on Laboratory Testing and Clinical Application of Cardiac Troponin[J].Chin Med J,2021,101:2947-2961.
[10]Talmor N,Graves C,Kozloff S,et al.Periprocedural myocardial injury using CKMB following elective PCI:incidence and associations with long-term mortality[J].Circ Cardiovasc Interv,2025,18:e014934.
[11]罗 琦,范志刚,周新军,等.基于冠状动脉斑块定量分析探讨经皮冠状动脉介入术后心肌损伤的影响因素及预测价值分析[J].现代生物医学进展,2024,24:1129-1134.
Luo Q,Fan ZG,Zhou XJ,et al.Explore the Influencing factors and predictive value of myocardial injury after percutaneous coronary intervention based on quantitative analysis of coronary plaque[J].Prog Mod Biomed,2024,24:1129-1134.
[12]Lis P,Rajzer M,KlimaL.The significance of coronary artery calcification for percutaneous coronary interventions[J].Healthcare,2024,12:520.
[13]Sogbadji J,Kadry K,Poletti G,et al.Impact of lesion preparation-induced calcified plaque defects in vascular intervention for atherosclerotic disease:in silico assessment[J].Biomech Model Mechanobiol,2025,24:539-552.
[14]Dai N,Chen Z,Zhou F,et al.Coronary CT angiography-derived plaque characteristics and physiologic patterns for peri-procedural myocardial infarction and subsequent events[J].Eur Heart J Cardiovasc Imaging,2023,24:897-908.
[15]陈思宇,白 琛,陈玉环,等.基于人工智能的冠状动脉CT血管成像斑块特征与血管周围脂肪衰减指数的相关性研究[J].实用放射学杂志,2024,40:721-724.
Chen SY,Bai C,Chen YH,et al.Correlation between coronary CT angiography plaque characteristics and perivascular fat attenuation index based on artificial intelligence[J].J Pract Radiol,2024,40:721-724.
[16]张粉丽,张永超.血清PDCD5、ADAMTS13对冠心病经皮冠状动脉介入术后心肌损伤的诊断价值[J].国际检验医学杂志,2025,46:1508-1513.
Zhang FL,Zhang YC.Diagnostic value of serum PDCD5 and ADAMTS13 for myocardial injury after percutaneous coronary intervention in patients with coronary heart disease[J].Int J Lab Med,2025,46:1508-1513.
[17]徐 艺,王均生,考国营,等.血清H-FABP、GDF-15、sICAM-1与PCI后心肌损伤的关系分析[J].局解手术学杂志,2023,32:898-901.
Xu Y,Wang JS,Kao GY,et al.Relationship between serum H-FABP,GDF-15,sICAM-1 and myocardial injury after percutaneous coronary intervention[J].J Reg Anat Oper Surg,2023,32:898-901.
[18]Naz A,Zhang S,An L,et al.Muscle-specific programmed cell death 5 deletion attenuates cardiac aging[J].Int J Cardiol,2021,345:98-104.
[19]Gu X,Bao N,Zhang J,et al.Muscone ameliorates myocardial ischemia-reperfusion injury by promoting myocardial glycolysis[J].Heliyon,2023,9:e22154.
[20]郭 鑫,滕 震,许泽祥,等.急性胸痛病人H-FABP、D-Dimer、NT-proBNP水平与急性胸痛评分的相关性及对主要心血管不良事件的预测价值[J].中西医结合心脑血管病杂志,2024,22:2063-2069.
Guo X,Teng Z,Xu ZX,et al.Correlation of H-FABP,D-Dimer,and NT-proBNP Levels with the acute chest pain score and their predictive value for major adverse cardiovascular events in patients with acute chest pain[J].Chin J Integr Med Cardio/Cerebrovasc Dis,2024,22:2063-2069.
[21]Zheng A,Huang N,Bean D,et al.Resolvin E1 heals injured cardiomyocytes:Therapeutic implications and H-FABP as a readout for cardiovascular disease & systemic inflammation[J].Prostaglandins Leukot Essent Fatty Acids,2023,197:102586.
[22]龚 宇,于 淼,田 甜,等.高分辨率磁共振血管壁成像评估大脑中动脉狭窄斑块特征与支架内再狭窄的相关性[J].介入放射学杂志,2024,33:1282-1287.
Gong Y,Yu N,Tian T,et al.High-resolution magnetic resonance angiography for assessing the correlation between plaque characteristics of middle cerebral artery stenosis and in-stent restenosis[J].J Interventional Radiol,2024,33:1282-1287.
[23]邢孔玉,凌学斌,高 飞,等.Lp-PLA2、H-FABP、Cx43水平与PCI后AMI患者预后及MACE风险的相关性[J].临床和实验医学杂志,2023,22:250-254.
Xing KY,Ling XB,Gao F,et al.Correlation of Lp-PLA2,H-FABP and Cx43 levels with prognosis and risk of MACE in patients with AMI[J].J Clin Exp Med,2023,22:250-254.
(收稿日期:2025-11-19)
(本文编辑:新 宇)

相似文献/References:

[1]马东星,吴晓霞,马春梅,等.冠心病合并室间隔缺损／穿孔同期介入治疗成功二例[J].介入放射学杂志,2010,(08):624.
　MA Dongxing,WU Xiaoxia,MA Chunmei,et al.Simultaneous performing of transcatheter closure of ventricular septal defect with rupture and percutaneous coronary intervention：report of two cases[J].J Intervent Med,2010,(09):624.
[2]何忆雯,秦永文,丁仲如.６４排螺旋CT冠脉成像在冠心病诊断中的应用[J].介入放射学杂志,2007,(01):10.
　HE Yi-wen,QIN Yong-wen,DING Zhong-ru.Preliminary evaluation of６４-slice spiral CT coronary angiograpy in patients with coronary artery disease[J].J Intervent Med,2007,(09):10.
[3]倪靖炜,沈卫峰,张瑞岩,等.冠心病合并慢性肾功能不全患者的临床特征和PCI远期预后分析[J].介入放射学杂志,2007,(03):152.
　NI Jing-wei,SHEN Wei-feng,ZHANG Rui-yan,et al.Clinical characteristics and long-term outcome of PCI in patients with chronic renal insufficiency[J].J Intervent Med,2007,(09):152.
[4]陈跃光,吕宝经.对比剂肾功能损害防治的研究进展[J].介入放射学杂志,2006,(06):382.
　CHEN Yue-guang,LV Bao-jing.The effects of contrast medium on renal function in selective coronary angiography and intervention[J].J Intervent Med,2006,(09):382.
[5]肖红兵,张大东,顾俊.通心络对冠心病支架术后 C 反应蛋白及预后的影响[J].介入放射学杂志,2007,(08):520.
　XIAO Hong-bing,ZHANG Da-dong,GU Jun.Effects of tongxinluo on C-reactive protein and clinical prognosis in patients after coronary stenting[J].J Intervent Med,2007,(09):520.
[6]徐迎佳,方唯一,杨向军.冠脉钙化小结血管内超声影像识别、发生率和分布特征[J].介入放射学杂志,2011,(08):606.
　XU Ying-jia,FANG Wei-yi,YANG Xiang-jun..The occurrence and distribution features of calcified nodules in coronary arteries determined by intravascular ultrasonography[J].J Intervent Med,2011,(09):606.
[7]邱向阳,梁 雨,李海燕.基于CiteSpace近10年冠心病介入治疗护理研究可视化分析[J].介入放射学杂志,2025,34(05):525.[doi:10.3969/j.issn.1008-794X.2025.05.015]
　QIU Xiangyang,LIANG Yu,LI Haiyan..CiteSpace-based visualization analysis of 10-year study on interventional nursing care for coronary heart disease[J].J Intervent Med,2025,34(09):525.[doi:10.3969/j.issn.1008-794X.2025.05.015]
[8]刘伟丽,廉哲勋,李大成,等. 支架精显技术在冠状动脉支架植入术中的应用[J].介入放射学杂志,2020,29(07):659.
　LIU Weili,LIAN Zhexun,LI Dacheng,et al.Application of enhanced stent visualization technology in coronary artery stent implantation[J].J Intervent Med,2020,29(09):659.
[9]王德玉,刘 辉,王 婷,等.手机短信服务对PCI术后患者治疗依从性的影响因素[J].介入放射学杂志,2020,29(09):946.
　WANG Deyu,LIU Hui,WANG Ting,et al.The effect of mobile phone short message service on treatment compliance of patients after PCI[J].J Intervent Med,2020,29(09):946.
[10]谢孟君,王春芝,张关禹.微小核糖核酸-590与急性冠状动脉综合征介入术后1年内支架内再狭窄的关系[J].介入放射学杂志,2022,31(01):69.
　XIE Mengjun,WANG Chunzhi,ZHANG Guanyu..Relationship between microRNA-590 and in-stent restenosis occurring within one year after PCI in patients with acute coronary syndrome[J].J Intervent Med,2022,31(09):69.

备注/Memo

备注/Memo:
基金项目: 济南市卫生健康委员会科技发展计划项目(2024310003)
通信作者: 王思月 E-mail:ftxhuren123@163.com
更新日期/Last Update: 2026-09-25